HomeMy WebLinkAboutPermit Electrical 1996-06-035P$':,.iFtELD
Tho following proi*t
zoning, and doas not
approvel.
as submktd l,,,s the
require sqecffla bnd
EIJCTRTCAL PEru{TT225 FI.t, slREEf,
SPRINGEIELD, OREGON 97477
IIISPBCTION RBQIEST| 726-3
OFFICE: 726-3759
769,,'',
Au'"ho rlzocl Si g nature
City Job Nunber
1 LOCATTON OP
q OA^oxpr.Frp- Pnn qcrrnPu1g BEI.Og
Service Included:
I tems
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Hanuf'd Home or
Hodular Dvelling
Sertice or Feeder
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
ior "rbt to 400 amps
-401 amps to 600 amPs
-
601 amps to 1000 amPs-
Over 1000 amps/volts
-
Reconnect OnlY
200 amps or Iess
201 amps to 400 amPs
-
0ver 401 to 600
Over 600 amps or
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit
SUBTOTAT OF ABOVE
52 State Surcharge
3Z Administrative Fee
TOTAL
Nev Residential-Single or
llulti-familY Per dvelling unit'
JOB DESCRIPTION
A.
B
c
Cos t
$ Bs.oo
s 1s.00
s 40.00
Sum
aEiE
Permits are non-transferable and expire
ii vort is not started vithin 180 days
;i i;;;;"" ot if vork is susPended for
180 days.
2. COI|TRACTOR INSTAIJ,ATION ONLI
Electrical Contractor ADT NIIRTTY
Address 150 I Pearl Street.sri te B
Ci ty 97 tt ?Phone (503) 342-1313
Supervisor License Number R-1777.IT.E
Expiration Date
Constr Contr. Number 5
Temporary Services or Feeders
InstalLaiion, Alteration or Relocation
$ s0.00
s 60.00
$100.00
$13o.oo
s300.00
$ 40.00
$ 40.00
s ss.00
$ 80.00
see ItBr
Expirat ion
Sigoature
Osners
Addres
Date Ll)q
ing Electrician amDs
1000 volts
D. Branch Circuits
0p4r Nev, Alteration or Extension Per Pane}
$ 3s.00
$ 2.00
Ci tySfCruan at>, ARphoneJ\4l' ( unnr--)
O9NER INSTALIATION
The installation is being made on
property I ovn vhich is not lntended
for sale, Iease or rent.
Omers Signature:
ry
E. Hiscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/0utIine Lighting_
Limited Energy/Res
-
Limited Energy/Comm .-rlL'ol)
s 40.00
$ 40.00
$ 20.00
s 36.00
DATE:
5
OFCITY
RECEIVED
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ALARI"I
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